thirty or forty and fifty years ago
there was a great science going on of
isolated organ in fact it under it has
underwritten to a very large degree a
lot of the transplant clinical success
for example an isolated kidney organ an
isolated heart had been one for a long
time an isolated lung isolated organs
can be brought to life even though
they've been removed from the animals
corpse sometime after death there's a
dog's heart it can function as well in
artificial conditions as in the living
organism and for this purpose blood is
introduced into the cardiac vessels the
isolated heart beats just as we did a
few hours previously in the living down
well a lot of people in those years were
very much interested in the isolated
brain and there were a lot of world
class people trying to isolate the brain
but nobody seemed to be able to prepare
a satisfactory isolated brain
preparation it was so difficult to
isolate without hurting it that if you
started taking the blood vessels away
well then never
going to the brain first thing we did
was isolate the brain and a dog which
was then removed and was sutured in to
the blood stream and through an incision
here another job with the appropriate
vessels exposed sutured the vessels of
the transplanted brain into those of the
animal but was covered with skin so the
dog literally had to break now you see
one of the advantages that we have that
other isolated organ experts didn't
because these were all incorporated with
electrodes record electrical activity
while this brain was in the animals body
this animal could get up and run all
over but when one of these brains was
getting bad well we knew that we had to
find what was wrong well that was the
first and so far the only true model of
a brain transplant we did some
experiments and monkeys which sort of
did the same thing but we use the
arteries in the abdomen so that the
brain was internalized into the
abdominal cavity one of the questions
that came up to us all the time
well dr. white do you know if this brain
is thinking is it alive I mean what is
going through its mind we showed them
these superb EEG records and look normal
but people wanted to see if it was
moving its eyes they wanted to see if it
would respond in any way now the
Russians have claimed the better part of
a century that they had developed a
two-headed dog I've seen the two-headed
dog and the animal does have two heads
and it was a great experiment I named a
demikhov who's and dead for some here
but the difficulty here was that this
was not a animal model but offer much in
the human range they couldn't figure out
what the idea was of a two-headed dog I
mean I don't think there were many
parents would want the kids sticking out
of their well I went back to the drawing
board to realize that the only way we
could do it is leave the cranial nerves
leave the nerves that are part of the
brain and head connected and that would
require something that people find
inappropriate and that would be a head
transfer
let's see one of the ethical problems
that comes up with these face
transplants not a brain transplant is it
this is not a matter of life of death
these people may look terrible and they
do look a lot better with a transfer
face or a facial transplant but the
bottom line is that the money the
involvement here this is not saving a
life now the operation you and I would
be talking about it would save a life
the family might raise the question why
can't our relative have a total body
transplant I mean after all you can get
a new heart we've set of lungs in some
of the great centers I think in
Pittsburgh they've done as many as four
or five organs one of the great advances
of the past century was the introduction
of brain death
that's human death and I think most
established religions are quite
comfortable with that how do we answer
the question now when the brain can be
supported by machinery and a sense it's
still alive and it is true that medical
science now believes that the definition
of death is an integral part of brain
function so that when the brain is dead
that a patient the person's dead now
under those circumstances it shifts a
tremendous amount of responsibility onto
those people who work with the brain
whether they be medical neurologists or
whether they be surgical neurologists
and indeed I did have an opportunity
more than a formative way to speak with
Pope Paul the sixth and his main
interest was really to understand and
see basic what we were doing he did not
of course obviously pass any sort of
moral judgment or approval on what we
were doing or in terms of this
definition but like many religious
bodies the Catholic Church is and should
be extremely interested in this area in
terms of the moral decisions that are
made
12:06 they met on a number of occasions
like I think I could consider him a
friend I really only knew two folks well
both ball six the other one that was
John Paul - well they're very much
interested and medical ethics the two of
them that I knew had a really amazing
knowledge of Medicine
I think there's some ways and very
honestly the idea of transplantation
began to dominate the whole sort of
field I mean outside in traits both
professional and unprofessional
began to focus almost exclusively on the
transplant model and then when we
decided to develop the technique of
transplanting the brain inside of a head
well then of course we were overrun I
welcome the opportunity to discuss a
very delicate subject which in some ways
the the literature past and present has
run ahead of us in terms of brain
transplantation
what you're asking me in a sense has
already been solved even going back to
the legendary Frankenstein legends and
so for everything
the brain is isolated and we must divide
all of its connections for vision
hearing and even movement because the
spinal cord which is in the back and
some serves our arms and legs also have
to be sectioned there's no way that we
can sew these connections back again but
what we have been able to do in the
laboratory to get around this problem is
actually to transplant the brain within
the hit under these circumstances even a
highly developed animal like a monkey
can actually see and hear and taste and
although it cannot enjoy any aspect of
movement
it is not impossible Tonya and so in
this situation you were looking at an a
animal body supporting a be animals
brain because this way it could see
taste and smell and so even in the very
first model that we were successful with
we knew and could see that this animal
was responding in this way one of the
concepts that came forward and doing
this operation we're now talking about a
brain transplant or more correctly a
total body transplant for tetraplegic
patients and the idea here was you would
take the diseased and crippled body of
the quadriplegic patient you'd remove it
and replace it with that of a young
healthy spinal cord injury patient was
brain dead so we felt well the
hypothermia work is there I mean that's
really the important thing the first
processes should put the catheters or
tubes in both monkeys then the next step
is to be able to transfer these
catheters from one animal let's say body
be two and a
we now have separated the head from the
body which has been removed and then
have you done the transfer you got to
turn it around and shorten these things
then you've got to figure out how to get
rid of these catheters and so the
vessels together
if the vessels are sewed together I
think then the the principle problem
becomes one of rejection tissue
rejection and also you were able to put
the spine together see the one of the
things that everybody forgets cuz you
got to work with the spine and the
spinal cord now it doesn't make me
nervous whether we sew the spinal cord
together or not just is not going to
work and so you gotta do a lot of
delicate work down there in the spinal
column with the spinal cord with its
vasculature so when you finally bring
the head over it just slide it down and
you're just put in a few screws we very
often drain the body that is not being
used but we drain the blood from that
into the other animals a transfusion
there should be another catheter in the
esophagus of the body which is going to
sustain the head and you can use that
for feeding personal purposes well I
think we'll hang in for about another 15
at 16 minutes you realize that the
monkey was not specifically trained to
demonstrate intellectual capability but
as soon as it's been decided for this
animal B to be awakened I can tell you
that because we left a cranial nerve
they could hear it could smell could
taste it would eat and it will follow
you around the room the tubes that were
placed in the mouth you could see them
chewing on them and we also see it was a
very unhappy monkey but I remember how
we felt because what we had transferred
here was yes another great number of
organs but we had cat and my judgment
transferred the soul the living
principle of this animal and course
could be done in human the probability
of something as complicated as the DNA
molecule being formed by random
collisions of atoms in the primary
notion this incredibly small dr. Hawking
is somebody that nobody cannot admire he
has been almost a living person
supported by computer technology but he
is already very limited in terms of body
movement are there people out there who
can provide us with so much knowledge of
the universe of course this is up to dr.
hockey at some point the issue and I
think he'll reject it will have to be
put forward yes
should he or should he not have a
body transfer his brain function
physiologically might even improve but
the point is that at the present time we
could do a total body transplant
well this sign has resolved the fact
that I had an argument with the owner of
this was a wonderful man by the way a
wonderful man I asked him out there
where my car is parked I wanted him to
write on the asphalt for MD only thanks
they wouldn't do it the next thing I
know he goes out and he has this sign
designed for me which I thought was a
little ostentatious
officially I'm supposed to been retired
for about ten years now and I really
missed the opportunity to go into a room
filled with high tech with a group of
other people almost invariably younger
than I am and try to save lives and to
be able to do it I've had wonderful
relations with patients I carried out
some very dangerous operations under
likes that any circumstances but I think
the factor of practice brain surgery and
spinal surgery for 50 years we never had
a malpractice suit brought against me
I'm very very proud of how there was
criticism of people very good scientific
people that don't agree with you know
the direction I've gone to me speaking
of our work in general that really
transgresses many important intellectual
fields that not just transplant biology
but philosophy theology that if what we
were doing was successful and would be
crossing new divisions that had never
been crossed before
is that long interview
after Alexis Carrel who pioneered the
transplanting of vital human organs as a
portion of an animal's pride 11 years
for this he received a Nobel Prize
that's so far surpassed a difference
surely you don't want to compare
yourself with dr. Karev
he was you me I to fight to preserve
life and the find that means to improve
the lives of future generations
you